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Social Determinants of Health

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A complex web of socioeconomic factors — from neighborhood characteristics to racial, ethnic, and gender disparities — often influence individuals' health outcomes. RAND research on the social determinants of health includes the effects of parks and green space on neighborhood physical activity and health outcomes, "food deserts," school meals, and more.

Higher levels of social spending are strongly associated with better health outcomes in many countries, with this link strengthening over time. The association also holds when looking at regional differences within the United States, where spending varies state-by-state.

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Libraries can provide much more than books and internet access. Libraries across the United States are evolving to play a bigger role in community health. Many offer nutrition programs, mental health support, and even free bike-shares.

By meeting the unmet health needs of incarcerated children, child health professionals can take the lead in addressing a major pediatric health issue while simultaneously addressing an under-discussed aspect of racial, ethnic, and socio-economic disparities.

Understanding existing stress levels within a community can help inform how it responds to acute or traumatic events. RAND researchers outlined a framework to determine cumulative community stress and how it may affect public health and community resilience.

The number of Medicaid recipients receiving medication to treat opioid abuse increased sharply in the years after approval of buprenorphine, but the increase was smaller in poorer counties and areas with larger populations of black and Hispanic residents.

The number of Medicaid recipients receiving medication to treat opioid abuse increased sharply in the years after approval of buprenorphine, but the increase was smaller in poorer counties and areas with larger populations of black and Hispanic residents.

This study found that a scale for measuring perceived powerlessness was valid among a demographically diverse sample of urban youth, showing promise for use in future health behavior and outcome studies.

Among a population of transgender women in Brazil, constant experience with gender-based discrimination contributed to a sense of trust with their stable partners, diminishing the desire to use condoms, and also contributed to poor mental health overall.

Locating a new supermarket in a low-income neighborhood may improve residents' economic well-being and health. Policymakers should consider broad impacts of neighborhood investment that could translate into improved health for residents of underserved neighborhoods.

The TV series “This Is Us” shows how health is not only affected by individuals' decisions, but also by the larger contexts in which they live. These social determinants of health include income, quality of housing, and access to health care.

The Early Childhood Environment Rating Scale-Revised -R shows positive associations to child outcomes up to a mid-level score of 3.4, beyond which it may lose its usefulness; a more process-oriented measure may be needed for classrooms at the higher end of the score distribution

People who move to a high-obesity area are more likely to become overweight or obese. This may be due, in part, to “social contagion.” Living in a community where obesity is more common may make inactivity, poor diet, and being overweight or obese more socially acceptable.

Behavioral decision research has traditionally examined how experimental manipulations evoke general cognitive processes; however, it is both feasible and valuable to study individual differences and their relationships to real-world antecedents, concomitants, and consequences.

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Researcher Spotlight

Senior Behavioral and Social Scientist

Wendy Troxel is a senior behavioral and social scientist at the RAND Corporation and an adjunct faculty member in psychiatry and psychology at the University of Pittsburgh. She is a licensed clinical psychologist and certified behavioral sleep medicine specialist. Troxel is…

Assistant Policy Researcher

Sangita Baxi is an assistant policy analyst at RAND and a doctoral student at the Pardee RAND Graduate School. She has an M.A.S. in health policy and law from the University of California, San Diego, and the California Western School of Law, and a B.S. in biology from the University of Michigan,…

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